tci ED Coding & Reimbursement Alert - 2017 Issue 8

Reader Question: Use Reopening and Not Appeals Process for Clerical Errors

Question: We submitted a claim to our Medicare payer and then realized afterward that it had a CPT® code on it that was missing a number — therefore, our clerical error is going to cause this claim to deny. Should we appeal? Sueprcoder.com Subscriber Answer: You should definitely fix the claim, but instead of launching an appeal, you can instead request a claim reopening to fix your error. What that means:  Reopening is a process for correcting a minor error or omission on a claim without having to pursue the formal appeals process. This is a completely...

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